Colorado Child Abuse and Neglect Campaign Partnership Form

Thanks for having interest in partnering with us. Everyone in the community plays a role in the prevention of child abuse and prevention, and our partnership strengthens our ability to achieve that shared mission. Please complete this electronic form and a representative will be in touch as soon as possible.

Account Information

Username *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, apostrophes, and underscores.

E-mail *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Password *

Confirm password *

Organization Information

Name *

501c3 organization, Government agency, or Community Group Name

How can you help? *

Support business community CO4Kids campaign partners

Become a foster parent

Become a CASA

Become a mentor

Get parenting advice and support

Help a foster family

Find child care

Adopt - foster care

Adopt - private and international

Based on the services you provide, select website category/ies for your organization so the public can find you when searching CO4Kids for specific ways to help in their community.

Opportunities *

Describe the opportunities your organization provides to individuals and groups to advance your mission and help the people who you serve. This information will be used to tell people about your work and how they can get involved. Please do not include contact information for specific staff members. Use a catchall phone number or email address instead.

Is your organization a child placement agency? *

Yes

No

Location you serve

Statewide, Specific County/Counties. Be specific. Specify if you provide statewide service. If your organization is not statewide, list every county you serve. This will affect how the public can find you on the CO4Kids website.

Logo

How would you like your organization to be listed: on campaign materials *